Lingual nerve impairment following impacted lower 3rd molar removal. A clinical study
Christina SOULIOU, Fotios BOUNTANIOTIS, Nadia THEOLOGIE-LYGIDAKIS
Department of Oral and Maxillofacial Surgery (Head: Professor I. Iatrou), School of Dentistry, National and Kapodistrian Uni- versity of Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2016) 1, 35-42
SUMMARY: Introduction: Lingual nerve injury is one of the most severe post-operative complications that may occur mainly during mandibular third molar surgery.
Aim: The aim of this study is to retrospectively examine lingual nerve injuries following wisdom teeth removal and review the relevant literature.
Material and Method: Τhe files of all patients who, under local anaesthesia, underwent surgical removal of impacted lower third molars, from 2008 till 2014, at the department of OMFS of the Dental School of Athens, were retrieved and data were collected regarding post-operative change of sensation.
Results: During the 7 years of the study 2094 lower 3rd molars were removed from 1481 patients. Lingual nerve impairment was registered in five cases (0,23%) and in one of these patients (0,04%) the change of sensation still remains.
Conclusions: Repeated and standardized follow ups of patients under certain principals, are essential for confirma- tion, evaluation of the degree of injury and possible treatment.
KEY WORDS: lingual nerve, trauma, third-molar removal
REFERENCES
Alling CC 3rd: Dysesthesia of the lingual and inferior alveolar nerves following third molar surgery. J Oral Maxillofac Surg 44:454, 1986 Behnia H, Kheradvar A, Shahrokhi M: An anatomic study of the lingual nerve in the third molar region. J Oral Maxillofac Surg. 58(6):649-
651, 2000
Benninger B, Kloenne J, Horn JL: Clinical anatomy of the lingual nerve and identification with ultrasonography. Br J Oral Maxillofac Surg. 51(6):541-544, 2013
Blackburn CW: A method of assessment in cases of lingual nerve injury.
Br J Oral Maxillofac Surg. 28(4):238–245, 1990
Carmichael FA, McGowan DA: Incidence of nerve damage following third molar removal: A West of Scotland Oral Surgery Research Group study. Br J Oral Maxillofac Surg 30:78, 1992
Gargallo-Albiol J, Buenechea-Imaz R, Gay-Escoda C: Lingual nerve pro- tection during surgical removal of lower third molars. A prospec- tive randomized study. Int J Oral Maxillofac Surg. 29(4):268-271, 2000
Graff-Radford SB, Evans RW: Lingual nerve injury. Headache 43(9):975-983, 2003
Haas DA, Lennon D: A 21 year retrospective study reports of hypoes- thesiafollowing local anesthetic administration. J Can Dent Assoc. 61(4):319-320, 323-326, 329-330, 1995
Hillerup S, Stoltze K: Lingual nerve injury in third molar surgery. Int J Oral Maxillofac Surg 36:884–889, 2007
Hillerup S: Iatrogenic injury to oral branches of the trigeminal nerve: Records of 449 cases. Clin Oral Investig 11:133, 2007
Joshi A, Rood JP: External neurolysis of the lingual nerve. Int J Oral Maxillofac Surg. 31(1):40-43, 2002
Kim SY, Hu KS, Chung IH, Lee EW, Kim HJ: Topographic anatomy of the lingual nerve and variations in communication pattern of the mandibular nerve branches Surg Radiol Anat. 26(2):128–135, 2004
Lam DK, Holmes HI: Oral surgery: Lingual nerve damage during re- moval of mandibular third molars: A comparison of two surgical methods. Oral Health 92(5):13-23, 2002
Mendes MBM, de Carvalho Leite Leal Nunes CM, de Almeida Lopes MC: Anatomical Relationship of Lingual Nerve to the Region of Mandibular Third Molar. J Oral Maxillofac Res 4(4):e2, 2013
Nguyen E, Grubor D, Chandu A: Risk factors for permanent injury of inferior alveolar and lingual nerves during third molar surgery. J Oral Maxillofac Surg. Dec;72(12):2394-401, 2014
Pichler JW, Beirne OR: Lingual flap retraction and prevention of lingual nerve damage associated with third molar surgery: A systematic review of the literature. Oral Surg Oral Med Oral Pathol Oral Ra- diol Endod. 91(4):395-401, 2001
Renton T, McGurk M: Evaluation of factors predictive of lingual nerve injury in third molar surgery. Br J Oral Maxillofac Surg. 39(6):423- 428, 2001
Robinson PP, Loescher AR, Yates JM, Smith KG: Current management of damage to the inferior alveolar and lingual nerves as a result of removal of third molars. Br J Oral Maxillofac Surg. 42(4):285–292, 2004
Robinson PP, Loescher AR, Yates JM, Smith KG: A prospective quan- titative study of the clinical outcome of lingual nerve repair. Br J Oral and Maxillofac Surg; 38:255-263, 2000
Ruggiero SL: Surgical management of lingual nerve injuries. Atlas Oral Maxillofac Surg Clin North Am. 9(2):13-21, 2001
Smith MH, Lung KE: Nerve Injuries after dental Injection: A review of the literature. J Can Dent Assoc. 72(6):559-564, 2006
Tan VL, Andrawos A, Ghabriel MN, Townsend GC: Applied anatomy of the lingual nerve: relevance to dental anaesthesia. Arch Oral Biol. 59(3):324-35, 2014
To EW, Chan FF: Lingual nerve retractor. Br J Oral Maxillofac Surg. 32(2):125-126, 1994
Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C: Lingual nerve damage after third lower molar surgical extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.90(5):567-573, 2000
Department of Oral and Maxillofacial Surgery (Head: Professor I. Iatrou), School of Dentistry, National and Kapodistrian Uni- versity of Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2016) 1, 35-42
SUMMARY: Introduction: Lingual nerve injury is one of the most severe post-operative complications that may occur mainly during mandibular third molar surgery.
Aim: The aim of this study is to retrospectively examine lingual nerve injuries following wisdom teeth removal and review the relevant literature.
Material and Method: Τhe files of all patients who, under local anaesthesia, underwent surgical removal of impacted lower third molars, from 2008 till 2014, at the department of OMFS of the Dental School of Athens, were retrieved and data were collected regarding post-operative change of sensation.
Results: During the 7 years of the study 2094 lower 3rd molars were removed from 1481 patients. Lingual nerve impairment was registered in five cases (0,23%) and in one of these patients (0,04%) the change of sensation still remains.
Conclusions: Repeated and standardized follow ups of patients under certain principals, are essential for confirma- tion, evaluation of the degree of injury and possible treatment.
KEY WORDS: lingual nerve, trauma, third-molar removal
REFERENCES
Alling CC 3rd: Dysesthesia of the lingual and inferior alveolar nerves following third molar surgery. J Oral Maxillofac Surg 44:454, 1986 Behnia H, Kheradvar A, Shahrokhi M: An anatomic study of the lingual nerve in the third molar region. J Oral Maxillofac Surg. 58(6):649-
651, 2000
Benninger B, Kloenne J, Horn JL: Clinical anatomy of the lingual nerve and identification with ultrasonography. Br J Oral Maxillofac Surg. 51(6):541-544, 2013
Blackburn CW: A method of assessment in cases of lingual nerve injury.
Br J Oral Maxillofac Surg. 28(4):238–245, 1990
Carmichael FA, McGowan DA: Incidence of nerve damage following third molar removal: A West of Scotland Oral Surgery Research Group study. Br J Oral Maxillofac Surg 30:78, 1992
Gargallo-Albiol J, Buenechea-Imaz R, Gay-Escoda C: Lingual nerve pro- tection during surgical removal of lower third molars. A prospec- tive randomized study. Int J Oral Maxillofac Surg. 29(4):268-271, 2000
Graff-Radford SB, Evans RW: Lingual nerve injury. Headache 43(9):975-983, 2003
Haas DA, Lennon D: A 21 year retrospective study reports of hypoes- thesiafollowing local anesthetic administration. J Can Dent Assoc. 61(4):319-320, 323-326, 329-330, 1995
Hillerup S, Stoltze K: Lingual nerve injury in third molar surgery. Int J Oral Maxillofac Surg 36:884–889, 2007
Hillerup S: Iatrogenic injury to oral branches of the trigeminal nerve: Records of 449 cases. Clin Oral Investig 11:133, 2007
Joshi A, Rood JP: External neurolysis of the lingual nerve. Int J Oral Maxillofac Surg. 31(1):40-43, 2002
Kim SY, Hu KS, Chung IH, Lee EW, Kim HJ: Topographic anatomy of the lingual nerve and variations in communication pattern of the mandibular nerve branches Surg Radiol Anat. 26(2):128–135, 2004
Lam DK, Holmes HI: Oral surgery: Lingual nerve damage during re- moval of mandibular third molars: A comparison of two surgical methods. Oral Health 92(5):13-23, 2002
Mendes MBM, de Carvalho Leite Leal Nunes CM, de Almeida Lopes MC: Anatomical Relationship of Lingual Nerve to the Region of Mandibular Third Molar. J Oral Maxillofac Res 4(4):e2, 2013
Nguyen E, Grubor D, Chandu A: Risk factors for permanent injury of inferior alveolar and lingual nerves during third molar surgery. J Oral Maxillofac Surg. Dec;72(12):2394-401, 2014
Pichler JW, Beirne OR: Lingual flap retraction and prevention of lingual nerve damage associated with third molar surgery: A systematic review of the literature. Oral Surg Oral Med Oral Pathol Oral Ra- diol Endod. 91(4):395-401, 2001
Renton T, McGurk M: Evaluation of factors predictive of lingual nerve injury in third molar surgery. Br J Oral Maxillofac Surg. 39(6):423- 428, 2001
Robinson PP, Loescher AR, Yates JM, Smith KG: Current management of damage to the inferior alveolar and lingual nerves as a result of removal of third molars. Br J Oral Maxillofac Surg. 42(4):285–292, 2004
Robinson PP, Loescher AR, Yates JM, Smith KG: A prospective quan- titative study of the clinical outcome of lingual nerve repair. Br J Oral and Maxillofac Surg; 38:255-263, 2000
Ruggiero SL: Surgical management of lingual nerve injuries. Atlas Oral Maxillofac Surg Clin North Am. 9(2):13-21, 2001
Smith MH, Lung KE: Nerve Injuries after dental Injection: A review of the literature. J Can Dent Assoc. 72(6):559-564, 2006
Tan VL, Andrawos A, Ghabriel MN, Townsend GC: Applied anatomy of the lingual nerve: relevance to dental anaesthesia. Arch Oral Biol. 59(3):324-35, 2014
To EW, Chan FF: Lingual nerve retractor. Br J Oral Maxillofac Surg. 32(2):125-126, 1994
Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C: Lingual nerve damage after third lower molar surgical extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.90(5):567-573, 2000
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